


Separate But Equal

by BettSpencer



Category: Shameless (US)
Genre: Alternate Universe - Hospital, Angst, Doctor/Nurse, Endgame, Enemies to Friends to Lovers, M/M, Mutual Pining, Slow Burn, Smut
Language: English
Status: In-Progress
Published: 2020-05-04
Updated: 2020-06-17
Packaged: 2021-03-01 22:27:56
Rating: Explicit
Warnings: No Archive Warnings Apply
Chapters: 9
Words: 14,430
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/23994520
Author URL: https://archiveofourown.org/users/BettSpencer/pseuds/BettSpencer
Summary: The one where Mickey runs an ICU and Ian is a first-year resident.
Relationships: Ian Gallagher/Mickey Milkovich
Comments: 87
Kudos: 134





	1. Chapter 1

Mickey tosses his phone back onto the bedside table after turning off the god-awful alarm, runs his hands through his hair, over his face and then starts bitching about July 1. He never works July 1, but his manager needed the entire week off for her daughter’s wedding, so he’s stuck running the unit during the residents’ first week. First year residents, fresh from medical school. Big heads – small brains. 

Stepping out of his shower, he wraps a plush towel around his waist. Expensive towels – one of his splurges after getting his shit together and a decent paycheck. Fancy towels and expensive sheets. Never again is he going to sleep on decades-old, hand-me-down sheets from his nasty big brothers. He pours his coffee and then steps around the bar into the kitchen to throw a few snacks into his backpack in case he doesn’t get time for lunch. He throws on sweats and a t-shirt, brushes his teeth, and heads to work.

Entering the hospital, he makes eye contact with no one. As he’s changing into his hospital-issued scrubs, he grunts a few grunts at his coworkers and then hits the floor. As assistant nurse manager, he charges two days a week and is in the office two days a week. Today he’s in charge. It’s his unit, after all. Mickey started his career here in the medical-surgical ICU as a graduate nurse eight years ago, working his way up from nights to days to charge to ANM. He’s been offered management positions, but who the fuck wants the hassle. Besides, Mickey loves the work of patient care. The thrill of the saves, the near-misses, the blood and guts. And his tell-it-like-it-is attitude is mostly appreciated by the doctors and the other experienced nurses, though seldom by management. The newer nurses shy away from him for a while, but he wins them over eventually. 

Ian awakens hours before his alarm. He’s already finishing his third cup of coffee, hoping the caffeine will drown out the nerves. He rinses his cup, steps into his sleeping area/living area of his tiny studio apartment, dresses in slacks and a button down shirt. Even though he will be issued scrubs in the hospital, he still wants to make a good first impression. He can’t believe it. Today he is a doctor. “Doctor Ian Gallagher.” He says it out loud again. “Dr. Gallagher. Dr. G if you’re nasty.” Ian giggles a little as his mind races a mile a minute. He puts on his backpack, grabs his bike helmet, and rides to the DART station. He locks up his bike, hops on the DART rail train and heads into work.

Ian meets up with his chief resident and the other first year residents in the doctors’ lounge as they’re changing into their scrubs. Apparently no one else worried about first impressions like Ian did. Oh well. Ian’s white coat is hanging in his locker – he left it there from his orientation last week since it was freshly ironed and starched. He slides it up his arms, over his shoulders, straightens out the collar, and glances at himself in the mirror. Right there in black and white – Dr. Ian Gallagher. He tries not to stare but he just can’t help it. 

Dr. Arnecke gathers his first years: Ian, Tony Jennings, and Nicholas Khan, and they prepare for introductions. The manager’s office is closed, the ANM office is closed, then Dr. Arnecke spots Mickey behind the nurses station. 

“Hey, Mickey. We've got new guys this year.” He steps back a bit and slightly waves his arm toward the three. “This is Nicholas Khan, Tony Jennings, and Ian Gallagher,” each one slightly waving a hand at the mention of their name. “Guys, this is Mickey Milkovich. He’s the assistant nurse manager and is the one to go to for pretty much anything. You in charge today?” Mickey does his famous nod-grunt combo while taking a sip of his coffee and Arnecke says softly, “Be nice please.”

Mickey quickly checks out these clowns. One of the draw backs of working in a teaching hospital is that there’s a swinging door of stupid new docs. Yeah, most of them figure things out and eventually do alright. But geez, putting in the work to turn these guys into self-sufficient doctors can be draining. Mickey tolerates it but his priority is his unit, his staff, and his patients. And Mickey can’t help but draw conclusions from just looking at these guys. Khan – nerdy, studious, he’ll probably be ok. Jennings – looks like a douche bag ladies man. And Gallagher – the most nervous, probably going to ask a million fucking questions. Sorta dig that red hair, though.

Morning rounds are interrupted by an admission from the Emergency Department. It’s one of those cases where the ED calls right after the patient rolls through the door and basically just says, “We’re coming!” This is the chaos that Mickey loves, though it only looks like chaos. It’s actually a well-oiled machine. The team works together wordlessly and gets the room ready, IV pumps, the monitors, the ventilator, the tubes for blood, and the equipment needed for line insertions. Then the patient is rushed in the room and moved swiftly and smoothly from the stretcher to the bed. As the other nurses connect the patient to the monitors, Mickey inserts an IV in the patient’s arm, and draws blood to fill each of the tubes. The IV is then used for medicine to sedate the patient so that they can be intubated and put on the ventilator. After that, an EKG is obtained, then a chest X-ray, then it’s time for one for the lucky residents to attempt his first line insertion. Arnecke turns to his residents and practically trips over Ian who is breathing down his neck, so Ian is picked for the task. His eyes wide with both nervousness and excitement, he steps out of the room quickly, removes his coat and hangs it on the chair by the computer outside the room. Arnecke just hollers out loud, “We need a central line kit.” 

Mickey is already in the process of handing him one and then makes eye contact with Ian and adds with a smirk, ”I’ve also got a second one for when he fucks this up.” Mickey catches Arnecke’s laugh along with Ian’s “shut the fuck up” under his breath and leaves the room – the patient stable and tests underway. 

Half an hour later, Mickey is rounding on his nurses and checks in on the new ED admit. He enters the room and sees Arnecke and Gallagher now on the right side of the patient completing the central line insertion. On the left side of the patient is a newly inserted chest tube, evidence that Gallagher did indeed fuck up the first attempt causing a pneumothorax. Mickey saunters in with a laugh, “Racking up the procedures today, huh, Gallagher?” 

Ian refuses to let Mickey, this fucking nurse, ruin his day. Yes, he missed the first central line, but he got the second one. And now he knows more about pneumothoraxes and how to put in chest tubes; so really it was a successful morning. Ian just completely ignores Mickey and finishes cleaning up his area and disposing of his sharps. Mickey, satisfied with the patient’s status, picks up his coffee from the computer area outside the room. As he’s turning to leave, he trips a little over the chair and spills some of his coffee on Ian’s white coat. And while it wasn’t intentional, Mickey isn’t altogether upset that it happened. He goes back to the nurses station and looks at the schedule for the night shift.

Reaching for his white coat, Ian freezes. He moves nothing but his head, looking forward, right, then left. As he catches Mickey watching him from behind the nurses station, Mickey lifts his eye brows along with his coffee cup and takes a sip, willing his mouth not to smile. Ian prays that his face shows no reaction as well, puts on his coat and joins Arnecke and the rest of the residents with the next patient. 

The shift over and hand off given, Mickey is heading to the employee lounge when he meets Ian on his way to the doctors' lounge right across the hall. Ian keeps his view straight ahead as he says, “You don’t seem very welcoming.”

To which Mickey replies, “It’s not my job to welcome you. It’s my job to protect my patients from you.”

And as they each turn into their separate lounges, Ian says softly,

“Asshole”

while Mickey says not quite so softly,

“Asswipe.”


	2. Chapter 2

Mickey enjoys the small gym at his apartment complex, mostly because there’s no additional cost, but also because people there just work out and leave – no assholes or juice-heads, and, thank God, no small talk. It’s on the top floor with a full wall of windows and a decent view of the Dallas skyline. His favorite time to work out is after his shift– it’s late enough that most of the 9-5-ers have already left and he gets to watch the sun set and the night life wake up. 

He’s just getting started when he notices a bike waiting at the red light across the street. Mickey watches the guy get off his bike, remove his helmet, and push his red hair out of his face. Mickey then sits up on the bench to get a better view, a leg on each side, watching….watching him wait for the light to change, watching him look both ways, watching him walk his bike across the street and straight into Mickey’s apartment complex. “Fuck, he lives here.” But then Mickey does an internal double take and thinks, ‘Wait – he lives here? In the middle of the gayborhood?’ For the briefest of moments, Mickey has visions of Ian’s red hair twisted all around his fingers… Mickey shakes his head clear, recalling that last time he attempted a no-strings-attached arrangement with a co-worker - did not end well at all. 

Ian loves his little studio apartment – everything about it. He loves the privacy, the uptown views, the proximity to the hospital, the public transportation, as well as accessibility to Ubers (not a lot of Ubers on the south side of Chicago). But what Ian really loves is that it is in an area of town where he can be accepted – he can actually be a part of his community. The clubs are just a block or two from his apartment. There is a grocery store right across the street from his new place. He’s heard about excellent jogging and bike trails close by, and he can’t wait for some time off to discover them. 

With his bike safely locked up downstairs, Ian is in his apartment enjoying the view, thinking back on his first day. He likes his peers. Jennings reminds him a little bit of Lip – super smart but an ass. Ian is not too worried about that though and he’s pretty sure they’ll get on just fine at work. They certainly won’t be clubbing together or, well, really they won’t do anything together outside of work. But that’s fine. He likes Khan a lot. He is quiet with a dry sense of humor, extremely smart and helpful – supportive almost.

As Ian closes his blinds and looks in the direction of the clubs, he scoffs a little, reminding himself that he really doesn’t need to be thinking too much of those. Yes, med school is over, but the real learning has just begun. He grabs his backpack, takes out his notebook, and sets it beside his bed - reading material for the next who knows how long. But first, the stain remover and a cold water soak hoping to remove the coffee stain from his white coat.

The next morning finds Mickey in charge again. Morning rounds are interrupted yet again, this time by Mickey’s pager going off with a rapid response team, or RRT call. He ignores the pager, but makes a quick mental note of empty beds and nurses available for urgent admissions from the floor. About half an hour later, Dr. Arnecke is sending Gallagher and Jennings to the transplant floor to see about the RRT patient with instructions to call him with updates. Dr. Arnecke then pulls Mickey aside and asks, “Do you have time to go check on that patient? Let me know what y’all need.”

He meets up with the residents at the elevator and catches a side eye from Jennings as Ian is asking, “What exactly does the rapid response team do here?” 

Mickey responds, “They just basically get the ball rolling. They can order tests and help the nurse sort things out. They also run the code blues until the rest of the code team arrives.”

“But they’re just nurses, right? No provider on their team?” Ian asks, just seeking clarification. 

“Yeah, they’re just nurses, but most of them have been critical care nurses since you were in fucking middle school, so they know a hell of a lot more than either of you do,” Mickey responds firmly and gets off the elevator first and heads toward room 1027. 

Entering the room, he finds Julie and Travis with the rapid response team, and several floor nurses helping the patient. The patient is an older woman who is in obvious respiratory distress, breathing over 40 breaths per minute. Jennings and Ian follow Mickey into the room with Jennings taking the lead asking what’s going on with the patient. Julie explains that the patient has a fever of 102.5 degrees and her pulse is in the 140s and the patient is now on 100% oxygen when she wasn’t on any oxygen at all an hour ago. As Travis is taking the travel monitor off the crash cart and putting it on the patient’s bed, Julie continues explaining that the patient is septic and needs to be transferred to the ICU, that she’s too sick to stay on the floor. 

Jennings scoffs a bit, might have even rolled his eyes slightly, and says, “Just wait a minute. Let me assess her and look at everything first. Plus I still need to call Arnecke and see what he says.” Jennings approaches the bed and asks the exact same thing that every other provider has already done. “Ms Frances, hi. I’m Dr. Jennings from the ICU. How are you feeling?” The patient moans a faint reply.

Ian is at the computer looking at lab results and leans toward Mickey and points out, “Look at these labs, though. I don’t think she’s septic; her labs look fine. Her white count isn’t elevated, her lactate is normal. What are they seeing exactly?” 

“They’re seeing the patient. Look at her – she’s using her abdominal muscles just to breath. Temp is 102, pulse is greater than 140, breathing super fast on a lot of oxygen with her levels barely hitting 90%. I don’t give a fuck what the labs say – sometimes the labs match the patient and sometimes they don’t. Always assess the patient, not the computer. I’ve got room 802 open – she can go there.”

Jennings is frustrated at this point. He hasn’t even gotten to call Arnecke yet and these nurses are trying to move the patient without any doctors’ orders whatsoever. “Just hold up a minute. I’m still looking things over and I still need to call.” He walks towards the computer as Ian backs away silently, but Ian is noticing that the nurses are still packing up the patient getting her ready to move. 

Mickey then asks the respiratory therapist if he’s run a blood gas yet; when answered no, Mickey tells him to get one. Jennings quickly looks up from the computer and barks, “Don’t order that under my name – I didn’t order that.” 

Mickey orders the blood gas under Jenning’s name. Ray brings back two copies of the results, handing one to the doctor and one to Mickey. Jennings looks at the results and mutters, “Fine. Bring her.”

The residents sit at the computer outside the room and enter orders for the transfer. Ian hears one of the rapid response nurses call bed control to notify them of the transfer and Mickey is already notifying his unit of the patient and what needs to be set up for her arrival. 

As the patient is rolled into room 802, Dr. Arnecke asks Ian what’s going on with the patient. Ian starts with a very professional, “Um..well..uh, she’s an 76 year old female with history of uh, transplant, a kidney transplant three years ago, admitted with septic UTI a week ago, a week and a half ago. Found this morning with fever and, um her, her rate high, oh.. her heart rate high. Her EKG just showed a fast heart rate and I wanted to order maybe a troponin to check for cardiac damage...and um, her H&H was fine, I mean all her labs are fine, but she’s on oxygen. I mean she wasn’t at first but now she is…” 

Mickey is just watching Ian tripping over himself, telling everything that isn’t important. Then he rubs his knuckle over his eyebrow and realizes he just can’t do it anymore. “She was febrile to 102.5 with heart rate in the 140s, blood pressure stable 130s over 70s, respirations greater than 40 and sats barely 90% on 100% oxygen – had been on room air until this. ABG showed 7.18, 86, and 45. During transport, her respirations became more shallow and slower and her sats dropped in the mid-80s. Barely responsive.” Mickey leaves the room to get more supplies.

While Ian is more mad at himself than at Mickey, he still angrily shoots Mickey a look as he passes, frustrated that he couldn’t just pull the information out of thin air and organize it like Mickey seemed to. The team is working together getting the patient settled and stabilized. As the residents are getting prepared for line insertions, Mickey quietly returns with his arms loaded. Arnecke asks for an art line insertion kit – Mickey hands it over. Arnecks asks for a central line insertion kit – Mickey hands him two. 

Ian quickly glares at Mickey and opens his mouth to say something, but changes his mind. Arnecke catches both men’s reactions and lightly nudges Ian’s arm, saying, “Don’t let him get to you, sometimes he’s a little shit.”

Ian scoffs and agrees, “Oh, he’s a big little shit,” trying not to keep looking at that little shit. 

Mickey grins at that and cheekily replies, “You’re welcome to complain to my supervisor if you’d like; Karen will be back in the morning.”

**Notes for the Chapter:**

> Medical terms that might help:
> 
> UTI - urinary tract infection
> 
> septic - when an infection gets into the blood stream and therefore becomes much more dangerous; they can present differently and are sometimes hard to catch
> 
> And please, if there are any terms that I don't explain, but you want to know about, feel free to ask


	3. Chapter 3

**Summary for the Chapter:**

> Is there any way to prevent the chapter 1 notes from popping up in each chapter? Thanks for any guidance.

The next morning, Ian arrives on the unit half an hour early, hopeful that he can get a calm start to the day. He notices that the unit manager’s door is open so he slowly peeks his head around the corner to see if it’s occupied. The woman at the desk looks up from her computer and smiles warmly, but questioningly. Ian puts on his best ‘great first impression’ smile and just goes for it, “Hi. You must be Karen.”

And her warm smile falls right off her face onto her desk and her eyes roll back in her head. Her sigh is loud, but followed by a little chuckle. “My name is not Karen. My name is Doris. You must be one of the new residents,” as she’s standing up and offering him a seat across from her.

Ian gasps, “Oh, I’m so sorry. I guess I misunderstood…”

“No, you didn’t misunderstand.” She waves her hand, grins, and speaks fondly. “Mickey’s a little shit. He calls me Karen whenever we have a difference of opinion and he just loves to tell people that’s my name. And you are?”

“Ian. Ian Gallagher,” he replies, laughing now. “Yes, actually, I’ve heard that exact phrase about him,” still smiling.

“How is your week going? Hope everyone is treating you well.” And Ian settles for a while and tells her what a great unit she has and that he’s excited about his opportunities here. She then asks, “You don’t sound Texan. Where are you from?”

“Chicago, actually. I was wanting a pretty big change in scenery after med school and was hoping to match at either the county hospital here or in Houston – I’m hoping for trauma eventually.”

“A lot of our doctors work at County also, so you might make some connections that can help you out. Mickey is from Chicago – did he tell you that? Apparently y’all have talked some?”

“No, we haven’t really talked much, except just work and patient stuff.” And then Dr. Arnecke taps the door frame interrupting the conversation.

“Hey, Doris. Welcome back. I saw the pictures you posted of the wedding – beautiful.” Turning toward Ian, “Come on, it’s you and Khan today. Let’s get a move on.”

Standing up and offering his hand, ”It was great to meet you, Doris.”

“Absolutely, Ian. You let me know if there’s anything I can do to help.”

After their shift, Ian and Nick went for a beer at the little bar down the street, blending right in with all the other hospital employees. Sitting at a table against the wall, they share how their week has gone. Nicholas has been working mostly the overnight shifts this past week, so they compare their patient situations, procedures, and outcomes. 

After a few beers, their shoulders and tongues a little loose, they start sharing staff interactions. They agree that most everyone has been welcoming and eager to teach when needed. Ian mentions that the only one that hasn’t been pleasant is Mickey; Nicholas notes that while he hasn’t met Mickey, he has heard that about him.

He then leans forward and starts sharing, “Look, my oldest sister is a nurse; been an ICU nurse for 11 years. Smart as a whip. I mean, not doctor smart, but totally completely smart. Nurses aren’t specialized like doctors are. They know everything – the good ones especially. They’re the ones who are with the patient 24/7, they see the trends, the patterns, and they know when something starts going off track. If there is a positive patient outcome at all, it is completely because of nurses. And she vents about doctors...boy can she vent. The doctors who don’t recognize what nurses do or who don’t respect their opinion – it goes all over her. If you have problems with any nurse, anywhere, ever, it’s a respect issue. They don’t feel respected.”

“But I never did anything disrespectful! He just started this way.” Ian’s voice is a little louder than he probably intends. Beer does that to him.

“Hey, that’s ok,” Nick says, laughing a little. “Nurses are usually just fine with new doctors until they get push back or they just start off defensive waiting for the disrespect. Mickey sounds like the second type.”

“I guess,” Ian mumbles and finishes his beer. Nicholas finishes his as well, and then states that he needs to head out since he’s due back in the morning. Ian decides to have another drink since he’s not scheduled for the next two days. As he’s walking up to the bar, he thinks of the boxes left to unpack in his apartment. He also thinks of the trails he has yet to discover. He’s not sure which direction he’ll take tomorrow. 

He orders another beer and two shots of whiskey. As he turns waiting for his drinks, he watches Mickey walk into the bar. Mickey in slacks. Mickey in a nice shirt tucked into belted slacks that hug his ass and thighs. Scrubs do this man no justice. 

Mickey slides up to the bar, tapping on it as he sits. The bartender pops the top off a beer bottle and hands it to him. Mickey realizes that eyes are on him. He caught Ian with his eyes as wide as his mouth staring at him as soon as he walked in– Ian isn’t exactly slick. As he swallows his first gulp, he mistakenly makes eye contact with Ian, which apparently means ‘come sit right here next to me.’ 

So Ian does just that, excitedly. “Were you at work today? I didn’t see you.”

Oh god. He’s already tipsy, Mickey realizes. “Meetings all day.” He tries to answer dryly.

“I knew my day was unusually pleasant,” Ian is grinning now, shooting the first whiskey, then picking up his beer.

“Miss me, huh?” Mickey huffs a quiet laugh.

Ian’s laugh is quite a bit louder. “No. No, I did not miss you. I did, however, meet Doris.”

Mickey turns with a beautiful smile and Ian probably choked on his beer. “Oh yeah? How’d that go?”

“She said you’re a little shit,” laughing. “She also said you’re from Chicago. I am too! What part are you from?”

And just like that, Mickey’s smile was gone. “Why did she tell you that? Anything about me outside of work isn’t any of your fucking business.” Mickey pushes away from the bar and goes to the table that Ian and Nicholas had vacated earlier. 

Ian panics and follows behind, drinks in hand, spilling a little, and helps himself to the chair next to Mickey. Mickey rolls his eyes along with his head, searching the room for help. “No, we weren’t talking specifically about you. She asked me where I was from,” then in his most exaggerated southern drawl, “said I didn’t sound like I was from these parts.” Ian giggles at himself. Mickey does not. Ian continues, more desperate than the situation actually calls for, “She just mentioned that you were from Chicago, too. Then Arnecke came and got me and we left. That was it. I promise, no one was talking about you.”

“Chill out Gallagher. You’re too fucking worked up.”

Ian admonishes himself for acting a fool and takes a long drink of his beer and big calming breath. Mickey is just watching him with a confused look on his face. Then Ian suddenly remembers, “I got my first central line today.”

Mickey scoffs. “You’ve gotten central lines. I’ve seen you get them.”

“Yeah, but this was my first first central line. I didn’t miss the first one – I got it.” And damn, Ian’s smile could light up a dark room.

Mickey caught himself staring at the brightness. “Hey, good for you, man.” And he smiles back. 

Quickly realizing that they’re both smiling like goofs at each other, and recognizing that alcohol-glazed look in Ian’s eyes, Mickey needs to leave. He looks past Ian’s head and sees a familiar face walk in. He stands up, nods his head in acknowledgment and leans over to get his backpack out of the next chair. Ian may have whimpered a little. Or maybe he just thought it. As Mickey is standing back up and catches Ian’s face, he smirks, “You sure do fucking stare a lot. You like my ass?”

Caught off guard for only a second, Ian makes direct eye contact, “It’s a lot better than your personality.”

Mickey barks out a laugh. He leans over the table, picks up Ian’s shot glass, and downs the whiskey. Holding Ian’s eye contact with the slightest of smirks, “Yep. It sure is.” 

Ian doesn’t move. He just keeps his eyes on that ass and watches it leave the bar with the tall blonde. Ian didn’t even catch what the guy looked like – he’s probably a prick anyway.

Fuck.


	4. Chapter 4

Ian’s alarm blares and he awakens with a groan. He had a two hour leisurely run planned for this morning only for his plans to be shattered by the crack of thunder and heavy storms. While he hates running on treadmills, he reluctantly pulls out his tablet and checks his downloaded movies and decides he can get through one easily enough. Thank goodness there’s a little gym in his complex. After two miles, Mickey walks in. 

'Seriously?' By the looks on their faces, they both had the same thought at the same time.

Mickey doesn’t acknowledge Ian; he just grabs a towel and the squirt bottle of sanitizer and goes over to the bench press. He cleans the bar and the bench and loads the weights. He pushes out his warm-up set, then adds a little more weight for the next set. He utilizes the mirrors on the walls to see that Ian is watching his every move. Ian hasn’t slowed down or adjusted or stopped or anything. The movie is forgotten and he’s watching Mickey and his chest and his shoulders. Mickey knows that Ian is watching. Again, Ian isn’t slick. But he’s not even trying to be. 

Mickey moves over to the free weights, grabs the 25 and pumps out a set of back rows. His back is strong, muscles cut, and perhaps he likes being looked at. He doesn’t mind observing either. The red hair, completely unkempt, soft without styling products, seems to have it’s own personality apart from Ian. Ian is stoic, focused on Mickey, running second nature without thought. That hair though – it’s like a fucking party and Mickey wants to grab it, twist his fingers in it, and hang on for the ride. And the stubble from Ian’s usually shaved beard. Jesus Fucking Christ. 

Ian has been watched long enough for his confidence to get a boost. He steps onto the sides of the treadmill, takes a sip from his water bottle, and then takes his shirt off. Then he nonchalantly hops back on and continues running. Mickey huffs and turns around, hands on hips. “Really?” He barks, eyebrows now hiding in his hairline.

“What?” Ian asks innocently, as he steps off again – the last thing he wants is to get tossed into the wall behind him while trying to play it cool. “It’s getting hot over here.” He throws out a toothy grin and continues his run. 

',Humph, two can play at this fucking game.' Mickey is well aware of his strengths and weaknesses. Words and emotions – weaknesses. His back and ass – fucking strengths. He removes his shirt, heading to the squat rack. He loads the bar and places it on the floor. He pulls up a few dead lifts, then tosses back a few cleans, knowing full well that lifting the bar from the floor to his shoulders makes his back muscles sing. With the next clean, Mickey squats, holding the bar against his collarbone, and popping out his spectacular ass. Two more clean-and-squats, then more weight is added to the bar, under Ian’s watchful eyes, of course. 

Mickey starts the process over with the heavier weight. A few dead lifts, a few cleans, then clean-and-squats. He sets the bar down on the floor again and turns around directly toward Ian, who, smiling cheekily, nods his head up in a silent ‘what’s up?’ Mickey takes a sip of his water, grinning around the top of the bottle, eyes on Ian, then turns back to the bar. He does his clean, easily catching the bar from his little toss. Then he squats, lower than before, and on his way up, he presses the bar above his head. His calves, thighs, ass, lower back, upper back, and shoulders are on brilliant display. Then as Mickey is lowering the bar to the ground, he hears a grunt and a thud from across the room, then a moan. 

Mickey rushes to Ian’s side, getting there as Ian is starting to sit up, already insisting that he’s okay. Mickey, always the nurse, asks, “Did you hit your head?” while looking into his eyes. 

“No. I hit my back. I’m fine. A little embarrassed, perhaps,” with a shy smile. Then he notices that Mickey is trying really hard not to laugh. “I don’t suppose you’ll just forget this, will you?” He holds out his hand toward Mickey for assistance.

“Oh hell no,” laughing now. “Nope, that was...can’t do it...that was unforgettable.” Standing face to face now, Ian realizes he has never seen Mickey smile before, much less laugh. It’s a full belly laugh and it lightens his whole countenance. Little wrinkles around his eyes and lips, his perfect teeth, those blue eyes shining, his cheeks full. Mickey is really beautiful and Ian wants to just touch him. What would he do if Ian were to reach out and stroke Mickey’s cheek with his thumb while his fingers are on Mickey’s neck inching toward that thick, dark hair? 

Mickey feels Ian’s eyes on his face, but he can’t seem to remove his own from the broad, sweaty chest in front of him. The muscles from the chest blend perfectly into the shoulders and the curve of the biceps right next to his abs. Those fucking tights abs, sprinkled with red hair starting below his belly button and leading into his shorts. Ian is really beautiful and Mickey wants to just touch him. What would he do if Mickey were to just reach out and brush Ian’s lower chest lightly with the tips of his fingers while his thumbs extend toward Ian’s abs desperately trying to reach that soft red hair? 

The gym door opening breaks the spell and they both head to their respective corners and put their shirts on. Silently agreeing that they’re done, they gather their belongings and walk out together, giving each other a side smile. “Why are you such a prick to me at work?” Ian finally gets the nerve to ask.

“Aw man, I don’t know,” rubbing his face lightly. “It’s not you necessarily. Work can be stressful, I get tired of fucking new docs and all the questions. I know I’ve been rough on you. I’ve been just as rough on Jennings, for whatever that’s worth.”

“Well, yeah, but he’s a dick,” Ian adds quickly. “Thinks all these nurses are going to want to jump into bed with him just because he’s a doctor.”

Mickey rolls his eyes and laughs. “Right. As if my nurses are the least bit impressed by stupid-ass new doctors.” 

As they reach Mickey’s apartment, Ian takes a deep breath and just lets it go, almost too quickly for Mickey to even understand. “Do you want to maybe hang out today, if you aren’t doing anything?”

Mickey stammers and stares at his front door for a few seconds before turning and catching the hopeful look in Ian’s face. He feels a soft smile release from his throat. “Um, well, I just have some errands to run. I need to hit the barber shop, was going to go by the little Greek food truck around the corner, then swing by the grocery store. You need to do any of that?” 

“Oh God, yes. I need a barber shop for sure. Look at this.” as he runs his fingers through his incredibly perfect hair. “This is ridiculous! It hasn’t been cut since before med school graduation and that was a little over two months ago. If you don’t mind, that’d be great.” So they agree to meet in front of the complex after they each take a shower and get cleaned up.


	5. Chapter 5

Staring into his closet, Mickey is spending way too much time picking out an outfit. It’s not a date; it’s more of an outing. He doesn’t want to give Ian the impression that he’s interested in a date. He’s sort of interested in fucking, but really, he knows that he shouldn’t fuck people he works with. But even recognizing all that, he wants to look good enough that Ian wants to fuck him. So it’s a tough call. Look hot, not trying to look hot, casual, but not lazy, while showing off his strengths. He picks faded snug jeans and an old concert t-shirt, pale blue which brings out his eyes, and old enough to be tight and soft. The thing about his eyes - Mickey thinks they’re just eyes. But he works with female nurses who go ga-ga over his blue eyes, always telling him that pale blue is his color. And in his personal, yet unscientific research, he has discovered that they are correct. Even guys like blue eyes. But anyway, casual. 

Ian isn’t trying for casual. I mean, he’s not going to dress as if going to a club, but he definitely wants Mickey to think he’s hot. So the less clothes, the better. After all – it’s a matter of showing off your strengths, right? He needs to be funny, smart, confident, laid back, sexy and open minded all while getting a haircut and going grocery shopping. It’s a tall order, really.

Ian is already waiting when Mickey exits the apartment building. He notices the red hair, perfectly fixed, and those damn shoulders uncovered by Ian’s sleeveless t-shirt. Running shorts show off his long muscled legs, with that soft red hair there too. “Why is your hair fixed if you’re just going to get it fucking cut off?” What he really wants to ask is ‘Why are you going to cut that hair before I can run my hands through it?’

“So they know how I wear it, goober. My hair is stubborn. It’s natural lazy state is bangs, like a fucking kid. I have to beat it into submission everyday,” grinning and lightly patting his hair. “You saw it this morning – ridiculous.”

“Hmm,” Mickey hums, keeping his thoughts to himself. After half a block of silent walking, Mickey says, “Chicago, huh? How’d you get all the way down here?”

“Well, it wasn’t easy, that’s for sure. I’m from the South Side, so there were disadvantages from the start. Drunk dad, absent drug-addicted mother. Kids raising themselves basically. My older brother was the only one expected to go to college, but he ended up flunking out and is now working on motorcycles. I barely graduated high school, not that I was dumb, I just didn’t try real hard. Didn’t care much. But then I became an EMT and loved that. I was taking classes to become a paramedic and realized that I enjoyed learning when I actually enjoyed the subject.” They waited at a crosswalk for a green light. “How much further are we going? Do you get the long version or the short version?” Ian asked, smiling.

Walking across the street, “We’ll take a left at the next street and it’s another block. You can give me the long version – we’ve got all day.”

Ian smiles loudly at the thought of all day, then he continues. “Well, okay, so then I started toying with the idea of being a personal trainer so I went to college to get my bachelors degree in Kinesiology. But as the tuition became due, I realized I didn’t want a ton of student loans, so I quit the ambulance and started dancing.” Ian paused, giving Mickey a chance to interrupt. But he just turned his head toward Ian, gave an eyebrow raise with a smirk and nodded his head to continue. “I started out bar-tending but damn, the money the dancers made.”

“Wait. Where were you dancing?”

“Um…..the Fairy Tale. It’s in Boys Town,” he answers quickly, hoping to move past it. But Mickey isn’t done yet.

“Dancing. Like, on stage dancing? Or private room dancing?” Mickey is telling himself to keep his eyes on Ian’s face and not to do a solid head to toe assessment right now. Imagining….

Ian moans a little moan. “Well, both actually,” Ian admits, before quickly adding on, “I was on the up-and-up though. I mean, there was a lot of whoring and drugs going on behind the scenes but I didn’t get involved with any of that. I just danced and took their money,” laughing reluctantly.

Mickey is still imagining. “You a good dancer?” He doesn’t make eye contact with that question.

“I don’t really think so. But I looked alright in the little gold booty shorts,” full on laughing now.

“Hmm. I bet,” mumbling a bit.

They arrive at the barber shop, the morning rush passed so they each get a chair. Mickey is with his regular guy who knows not to chit chat. Ian, however, is telling his guy all about his recent move to Dallas and how he’s finding the city. As glorious red hair litters the floor, Mickey hides his grief. That damn mirror is covering the entire wall and Mickey bites his lip watching the barber running his hands through Ian’s hair. Every time he’s caught staring, Ian smirks as Mickey looks away feeling the warmth coming up his neck onto his cheeks. 

Mercifully, Mickey is finished first and gets a chance for a cigarette outside while catching his breath. When Ian joins him, they take off toward the food trucks. There’s a little side street with usually four or five food trucks each day. Mickey’s favorite is the Greek truck run by a little old Greek woman and her two daughters. Ian takes in the selections: Greek, Chinese, burgers, and barbecue.

“Are they all pretty good?”

“Pretty much,” Mickey replies. “I usually go to the Greek one. I like their gyro a lot, plus the family that runs it is nice, reminds me of home.”

“That sounds good. I mean, I don’t know what a gyro is. But I’m game.” Ian is having a hard time containing his smile.

“A gyro - lamb, onions, tomatoes, pita bread. Good stuff.” Mickey orders for them and pays, waving away Ian’s wallet, each getting a gyro and bottle of water. The woman at the window immediately grins wide, calls him by name and asks how work is going. Then she slyly looks over at Ian, then back at Mickey with a questioning look on her face. She’s met with a stern look basically telling her to keep her mouth shut, then a little closed mouth grin. The woman then turns and screams to her daughters in a foreign language, getting screams in return, then rounds of laughter. 

“Reminds you of home?” Ian inquires while moaning over his food. “Were you raised by a Greek family in Chicago?” 

“No, my aunt raised me and my sister here in Dallas after my folks died. Lots of screaming, not angry, just loud. Mostly just giving each other a hard time,” Mickey remembers fondly.

“Where’s your sister now?” 

“She’s still here in Dallas, well right outside of Dallas in Rockwall. Works in a bank doing some shit with new accounts, has a little boy, Jamie, he’s 3.” With the sandwiches eaten, they clean up their table and start heading toward the grocery store. “Okay. So you’re dancing for old creeps and going to college. Continue.”

“Hey now, they weren’t all creeps. But yeah, I’m taking all these anatomy and physiology classes and loving them so I started looking into med school. I was stupid enough to tell myself that I was just adding pharmacology stuff – I basically already knew the rest.” They both bark out a laugh at that.

“Oh God – could you have been any more naive?” Mickey hits him with his shoulder at that.

“No, I could not have,” both still laughing. “But luckily I was that dumb or else I wouldn’t have thought I could do it. But of course it got stupid hard, but by then, my student loans were already outrageous. So basically, I realized that if I didn’t graduate and earn a doctor’s salary, I would be totally fucked for life. So I basically scraped it out – not a great GPA, but good enough for a degree. I wanted to match either here or Houston in the county hospitals – I wanted the worst trauma there was with my background – just figured I’d be most comfortable with that. But ended up here. Khan was telling me how this might work out better anyway – an internal medicine background will help me with trauma patients eventually. So I’m here for now, in a tiny ass studio apartment, living on my own for the first time, staring down a couple hundred thousand in student loans with no decent salary for another four years,” Ian turns toward Mickey and gives him a little self-deprecating smile. 

“Just be patient. All your hard work will pay off.” 

They cross the street to the grocery store and each grab a cart. Ian is pleasantly surprised when Mickey actually stays with him and doesn’t take off by himself. They start off in the produce section, then go up and down each aisle, neither with a list. They discuss foods they love, such as fruit and ice cream and beef, especially ribs, though Ian prefers pork ribs to beef ribs. They also share foods they hate; Mickey hates most frozen vegetables while he doesn’t mind canned, and Ian hates cheese which really doesn’t make sense. Then they start talking about foods they used to eat when they were growing up poor, with both deciding that they’ll never eat Hamburger Helper again, and Ian admitting that he isn’t ready for spaghetti yet either. However, they both wholeheartedly agree that they could never get tired of a big breakfast. Then Ian starts describing his meal-prep routine, which Mickey teases him about since basically “meal-prep is just left-overs gentrified.” Ian can’t argue. 

Approaching their complex, Mickey realizes he had a much better time than he expected and Ian really doesn’t want it to end. Trying to force himself to remain chill, Ian forces himself to look directly at Mickey while asking, “Would you maybe want to go out sometime, a drink after work or something?”

‘Oh, Ian, don’t do this.’ Mickey continues facing Ian but drops the eye contact. Ian seems like a nice guy, ambitious, hot as fuck, but he seems too settled, too sincere. Mickey isn’t the dating type, not a single bit. His idea of a significant other is fuck buddy with a name. “Look, I don’t...I just don’t date. I mean, I mostly just fuck, you know?”

Ian reigns in his reaction, forcing a sly grin. “Well, okay, we can do that too.”

“And I sure don’t fuck with people I work with. Come on, man, you understand that.” He’s feeling awkward now, rubbing the edge of his nose. He turns his body slightly toward his front door and retrieves the key out of his front pocket. 

Ian, for whatever reason, is feeling confident. He knows Mickey is hot for him – he sees it and he can feel it. Fuck, Mickey even blushes. So Ian crowds Mickey a little against his front door, looks down into his eyes, speaks a little softer. “What if we didn’t work together? Would you be down to fuck?”

“We do work together,” Mickey croaks out, his back now flat against the door behind him.

Softer still, “But if we didn’t, would you want to fuck?”

Staring straight ahead at Ian’s neck and desperately trying to avoid looking at his lips or eyes, just above a whisper, “Probably.”

A smirk, a faint moan from his throat, and Ian pushes off the wall and heads towards the stairs to his apartment. He decides that while batch cooking for the week, he’ll formulate his next step.


	6. Chapter 6

Little did Ian know, his next step would be that very night – and he wouldn’t even be aware of it. 

“Hey man, what can I get you?”

“Let me get a shot of well whiskey and a draft.” Ian pulls himself onto the bar stool and looks around. It was his third bar that night; he was just hopping from one bar to the one next door waiting for something to feel right – something to make him want to stay. He’s been in Dallas for close to two weeks now, and all he’s done is unpack, work, and met a couple of trails. His eyes adjust to the dark lights as he looks over to the dance floor and sees something that makes him want to stay. The bartender is about to generate some small talk when he notices a complete change in Ian’s expression. Ian’s whole body now turns on the stool toward the dance floor and the bartender follows Ian’s vision, puffs out a smirk, and turns on his heel. 

It’s Mickey. His skin brighter than usual under the lights, his dark hair blending in with the dark walls, full pink lips around an open mouth, tight jeans, some asshole wrapped around his shoulders from behind. Mickey is barely moving his feet, just grinding his hips back into the asshole’s crotch. Mickey’s arms are up and back, holding the asshole’s head against his exposed neck, getting licked and sucked, laughing at something the asshole says, then starting to walk away. Asshole follows him – who wouldn’t – and Mickey stops at a table to down a shot then they head toward the back, Mickey leading the way. 

Dammit. Ian stands up, looking around as if lost and unsure where to go. Is it creepy to follow? It’s probably just the restroom, right? Maybe if it were just a coincidence it wouldn’t be as creepy. Fuck, it’s probably creepy no matter how you look at it. Ian by now is just pretty much letting it be known that he’s down for anyone and someone finally approaches. He attempts small talk but Ian interrupts, “Do you wanna chit chat or do you wanna just get busy?” When the guy offers his nearby apartment, Ian declines, obviously more anxious than that. The guy looks pretty pleased with that, flattered even. Ian rolls his eyes, thinking, ‘Whatever.’ So they head to the back.

Ian’s eyes need a few seconds to adjust to the really dim lighting, almost a navy blue haze from all the smoke. He slows down and takes in the scene. A long dark hallway, maybe with little alcoves in the wall, it’s hard to tell. He sees numerous couples in various positions. He really doesn’t want to stare, but he finds himself checking out each couple to see if any of them are Mickey. He breathes in the smell – he actually likes it. An appetizing mix of smoke, alcohol, cologne, sweat, and sex. But no Mickey. Ian is caught off guard as the guy then pushes him up against a wall and attaches himself to his neck. And while he was really hoping to find Mickey (and do what, exactly?), he wasn’t going to turn down a blow job. Ian rubs himself into a semi and then unbuttons his jeans and sticks the guy’s hand into his pants to finish the job. The guy hums against Ian’s neck, “Damn, you’re big.” 

Ian hums back, “You gonna suck it?”

“Fuck yeah. Return the favor,” and he drops to his knees.

Mickey is in a dark alcove, invisible to everyone – he knows where to stand for the best seat in the house. He’s getting comfortable when, holy shit Ian is being dragged in here. Mickey is watching Ian, who is walking slowly, probably needs to let his eyes adjust to the dark, but wait – he seems to be completely perving on all the people – staring for a little too long at each couple. ‘What the fuck is he doing?’ Mickey watches Ian get tossed against the wall, then the guy attaches to his neck and unbuttons a couple of shirt buttons, rubbing Ian’s chest and abs and kissing trails to Ian’s soft red hair. He then watches Ian unbutton his pants, and shove the guys hand in, watches the guy drop to his knees and pull Ian’s cock out. And holy fuck - it’s beautiful; it’s long, thick, and probably reaches past Ian’s belly button. Mickey lets out a little moan and the dude on his knees in front of Mickey looks up, pleased at the response. Mickey keeps his eyes on Ian.

He keeps watching. Ian leans his head back against the wall, mixes his fingers in with the guy’s hair who’s attached to his dick, watches the guy lick all over the head while stroking, using spit for ease. Ian’s eyes are beautiful and lazy and his mouth is open, and his hips start to thrust. Mickey watches the guy take more in his mouth, no way can he deep throat all that – hell, Mickey wasn’t even sure if he could. But he sure would fucking give his best shot. The guy unbuttons the rest of Ian’s shirt, rubbing his fingers all over Ian’s abs and wrapping them around his waist to his back and then pulls Ian further into him. The dark blue lights illuminate Ian’s abs, softening all the cuts into delicious curves. Both of his hands are on Ian’s ass, holding him deep; it’s impressive, really, how much the guy can take. Ian’s eyes shut, his face relaxed, mouth open. Maybe if Mickey listens hard enough, he’ll be able to hear Ian’s moans above the rest. He really wants to hear them; he wants to lick behind Ian’s ear, to hear Ian struggling to maintain composure, wants to hear a soft, broken moan, with a sprinkle of a whimper floating off it. He wants to whisper, “You like that?” He wants to hear Ian struggle to string together words. 

Ian’s hips are thrusting harder now, they guy needing his hand to help his mouth. As soon as Ian really gets moving, the guy stops and goes back to licking the glorious thick head, sucking the drops down. Ian wants to come so fucking bad – Mickey recognizes the lust and need in Ian’s hips. Ian finally just grabs his own cock, pulling it out of the guy’s grasp and jerks it fast until he comes all over the guy’s face and mouth. His head is flexed forward at the beginning of his orgasm, eyes tight and teeth clenched. Then his head is against the wall as he starts coming down, his eyes and face more relaxed, his mouth open and plump and god-damn, Mickey wants to kiss him. He wants a lazy, sloppy, salty kiss while gently stroking Ian’s dick until Ian shivers head to toe.

As soon as Mickey saw Ian grab his own dick, and the guy obediently open his mouth, he imagined himself there swallowing Ian down. His own hips now thrusting, with quiet moans, Mickey comes and the guy licks him clean. Mickey can’t quit staring at Ian’s post sex face, cock mostly still hard, wet and shiny. Mickey’s guy stands up and hits him in the arm. “Hey asshole, you’re not even paying attention to me!” 

It was the second little punch that finally got Mickey’s attention. “Ay, what the fuck, man? Yeah, I’m fine,” Mickey responds absently.

“I know you’re fine, you little shit, I just sucked you down.” Realizing that’s true, Mickey laughs a little and keeps staring at Ian. “Who’s got your eye? Oh, red hair and all the abs?” The guy pulls out his cigarette pack and offers one to Mickey. “Here ya go, I don’t guess I’ll be getting anything from you tonight.” He lights his cigarette, grins at Mickey, and turns toward the exit. “See ya later, Mickey.”

Mickey puffs on that cigarette, still in the dark corner, unseen, still gazing at Ian. He’s now on his knees and pulls the guy’s pants down a bit after the guy unbuttons them, his fucking beautiful long tongue going straight to the balls, sloppily licking all up under and around them while slowly stroking the guy’s dick. A full erection now, Ian wraps his tongue around the dick and bobs his head up and down a couple times while continuing to cradle him. Ian’s hand is still under the guy’s balls, his fingers now hard to see even with the guy’s foot up on Ian’s thigh. But goddamn, Mickey knows where those fingers are – just by watching the guy, Mickey knows. 

Ian’s mouth is now just steady up and down on him, his hand palming his balls with his fingers making the guy dance, thrusting both forward and back. 

Mickey can’t watch anymore. Fuck, he’s fucking hard again and just wants to get home and take care of it himself. He hits the bar to settle his tab. The bartender, Stu, smirks at him, “You’ve got an admirer.”

Mickey has already turned toward the door. “Whatever, see ya.”

Mickey gets home and is quickly in bed, one leg with his knee bent. As he’s stroking himself, he already sees Ian looking up at him, his pink mouth on Mickey’s thick cock. Mickey twists his fingers in that fucking long glorious red hair, plenty of hair to grab and fucking hang on to. He can feel Ian’s tongue playing with his balls, lightly sucking and nipping his thighs and ass, licking around his hole, ghosting the opening. Mickey is moaning loudly and Ian is smiling at him with bright eyes, spit hanging from his chin. Ian slides up Mickey’s chest and kisses his neck and whispers in his ear, “You’re so fucking hot, Mick.” And Mickey’s hand is flying, his hips are dancing and he’s fucking singing. He comes hard and as soon as it hits his stomach, Ian is there licking it up and then kissing him and it’s sloppy and salty and wonderful and they’re both smiling. 

Several heavy breaths later, Mickey opens his eyes, alone, exhausted. He slowly heads to the bathroom to clean up and then goes back to bed to sleep. 

The next morning at the hospital, they see each other across the unit. Ian struggles not to see Mickey on the dance floor, holding the head behind him with his neck exposed and hips grinding. Mickey struggles not to see Ian licking his way up his stomach toward his lips. Turning away, Mickey lectures himself. ‘Get a grip, Milkovich. He might be pretty and hot and nice and almost perfect, but he’s a coworker and a dumb ass first year. Keep your head out of your ass…..and out of his.’


	7. Chapter 7

Mickey’s pager goes off – an RRT on the floor. He does a quick mental scan; he has one room empty but it’s dirty. He swings by there and makes sure that housekeeping is almost finished. Next is the phone call – an urgent demand for the Level 1, along with a request for help; obviously the rapid response team is going to be giving blood, and lots of it. The last page is the code blue page. Mickey and the residents take off to the stairs, leaving a co-worker at the elevator with the Level 1 blood infusion machine and blood tubing. 

They arrive to an already crowded room, the patient writhing and moaning on the bed, obviously not in arrest yet, but judging by the amount of blood on the floor and in the bed, it won’t be long. The room is seriously a mess – lots of nurses focused on cleaning up the blood, but no one is holding pressure on the site; Mickey can’t even tell where the patient is bleeding from. Mickey approaches the crash cart and grabs the pads and starts to attach them to the patient’s chest. As he’s doing that, the first familiar face he sees is Ian’s, so he orders him to hold pressure. Ian grabs a few gauze pads and approaches the bed. 

Mickey barks, “Grab that towel, it’s her femoral artery, put your whole weight on it, directly on top, hard!” Ian holds pressure with his hands and maybe utilizes his arms a bit. Mickey barks louder, “Your entire body weight, directly over the site and PUSH!” 

The patient moans louder, the only response she can make.

Mickey’s demand for lab tubes is answered by one of the nurses and he gives them to the RRT nurse to fill them with blood. He verifies that the primary team has been called and then he pushes Jennings off the computer so he can order MTP – massive transfusion protocol. When he hears Jennings mumble that the patient isn’t even coding, Mickey responds firmly and in his face, “They needed help – it was an appropriate call.” The Level 1 arrives and Mickey and his co-worker start priming the tubing getting it ready for the blood. 

The primary team arrives and makes a quick assessment, confirming that the patient’s infected femoral patch must have disintegrated, leading to a femoral artery blow-out. They ask for MTP – Mickey states it’s already been ordered and someone has been sent to the lab for the first two units of blood. They ask for lab work and Mickey states that it’s already been drawn and sent to the lab. One of the primary team providers is now on the phone with the OR scheduling the urgent case; the other is on the phone with the vascular surgery team. The patient is now unresponsive, but still has a pulse and is breathing; Ian is still holding pressure and no one will let him release pressure to see if the patient is still bleeding. Looking at the bed, the floor and the suction canister on the wall, the patient has probably lost a liter or two of blood. 

A tech arrives with the first two units of blood and Mickey and his co-worker verify the blood to the patient, while the RRT nurse is spiking the first unit of blood and hooking it up. Within about a minute, the first unit finished, the second unit up and then vascular surgery shows up. They ask Ian to remove pressure to check the site – it’s still oozing a bit but not gushing as before. They verify the OR is ready, the team is in place, and they pack up the patient to leave. The cooler with the rest of the blood products is brought to the room, so Mickey and the RRT nurses verify those products while hanging them one by one. 

Ian continues to hold pressure and Mickey continues to hang blood products and the team is slowly moving down the hallway to the elevator to the OR. After they drop the patient to the OR, handing off to the anesthesia team, Mickey returns to his ICU and makes sure his empty room is ready for this patient after surgery.

Dr. Arnecke approaches Mickey about an hour later, “Hey, you did great back there. You’re always good under pressure.”

Mickey isn’t good at accepting compliments. “Eh, just doing what needed to be done. Where are your puppies, did you lose them?”

“I let them stay and watch the surgery. We’ve already rounded here and I didn’t expect anymore procedures for them today.” 

The rest of the shift went smoothly. Several of the crew are going to the bar across the street for drinks after work and they invite Mickey along. He usually goes for one drink, feeling obligated to participate, but not wanting to let his guard down completely with them. He is one of their managers, so there’s a fine line. With most of the chatter this evening about families and kids and weekend plans, Mickey mostly just listens, sipping his beer unhurriedly. 

His bottle now empty, he approaches the bar for some small talk with the bartender – a familiar face for years now. He looks up into the mirror behind the bar when he hears the door open and sees his residents walk in, accompanied by a couple other guys that Mickey doesn’t recognize – probably other residents since they generally stick together. They take the table directly behind him, none of them making eye-contact with Mickey in the mirror. 

Jennings is talking animatedly, keeping everyone’s attention. “So we walk in and this lady is bleeding out everywhere, all over the floor, the bed, the walls, fucking everywhere! We had to attach her to the defibrillator because she was about to fucking code! Anesthesia was there to tube her…” 

Mickey quietly orders two shots of whiskey, downs one, and looks up in the mirror watching the guys all googly-eyed, hanging onto every word out of Jenning’s mouth. Except Ian – Ian is watching Mickey watch him, then turns his eyes toward Jennings and realizes what all he’s saying. 

“And then we gave her blood, fuck, I don’t even know how many units of blood we gave her…” 

Mickey slowly turns on the bar stool, directly facing the table with both his elbows resting on the bar behind him. Ian catches his eyes and tries to hide his little grin. 

“Then surgery finally gets there and we get her down to OR.”

“Mickey gave the blood,” Ian said softly, catching Jennings eyes after the statement was out there.

“What?” Jennings was taken aback.

“Mickey gave the blood. And attached her to the defibrillator.”

“Who? Mickey? Oh, that fucking nurse? Well, yeah, nurses do all that type of shit,” Jennings waved his hand condescendingly.

“And Mickey made sure the bleeding stopped. You were just standing in the fucking corner.” Ian’s voice was pretty firm by now – he really didn’t like this guy. 

Ian had a front row seat at that incident; he watched Mickey run the room and barely remembers Jennings hiding in the corner. Sure, tell the story, but don’t try to take credit for shit you didn’t do. Mickey grins and spins around in his chair back toward the bar, catching Ian’s face in the mirror, watching Ian stand up from the table. Mickey jumps when the phone in his back pocket rings and then jumps again when Ian is standing right next to him.

“Your ass is calling me,” Ian’s voice is soft as his face swings close to Mickey’s as Ian is taking the stool next to him. 

Mickey looks at his phone and rejects the call. “Very funny,” perhaps even rolling his eyes in response. He downs his second shot, then signals for two more, passing one over to Ian when they arrive. Mickey wants to tell Ian that he doesn’t need to do that shit, Mickey doesn’t need recognition for what he does. But at the same time, he doesn’t want to make a big deal about it. Ian probably wouldn’t have even said anything if Mickey wasn’t sitting right there, listening. So Mickey turns to face Ian and raises his shot glass along with his eyebrows and the corners of his mouth. “My ass hung up on you.”

Hands across his chest, as if offended, “I would never reject your ass.” They take their shots together, both smiling at each other. Ian looks down at the bar, “How was your day?”

Mickey huffs a small laugh, “It was fine, dear. How was yours?”

Looking up at Mickey through his lashes, “It was good,” Ian answered softly.

Mickey’s smile drops from his face. “I don’t need you to defend my honor, you know. I know what all I do and I don’t give a shit if anyone else knows or not.”

“Oh I know, but fuck! I hate that guy. Did you hear him? Going on and on as if he actually did anything! I mean, I did the most important job.” Ian leans back with a big grin on his face.

Mickey barked out a laugh in response. “Hmm, a fucking monkey could’ve held pressure.”

After a slight hesitation, “Well, yeah. And he’d have done the most important job.” They’re both laughing now. Ian continues, forever the optimist, “Can I get you another drink?”

Mickey looks away regretfully. “Nah, man. I only meant to have a beer, but got distracted. I need to get going.” Mickey stands and pulls out a couple of 20s and tosses them on the bar and nods toward the bartender. Before he turns to leave, he gives Ian something to hang onto. “You can buy next round.”

Ian ducks his head to hide his smile, but he feels the warmth coming up his back to his neck. “I’ll hold you to it, Mick.”


	8. Chapter 8

Right after he hears the monitor alarm from room seven, Mickey then hears raised voices talking over each other. He glances down the hall and sees Dr. Arnecke sitting outside the room watching the activities through the window. 

“Hey, what’s going on?” Mickey questions as he enters. 

Ian looks like shit, his face is paler than usual with dark bags under his eyes and his usual charm is just completely gone. 

“I’m just trying to give this patient some adenosine to slow his heart rate down and your nurse is arguing with me!” Ian’s arms point toward the patient, then the monitor, then toward the nurse.

She rolls her eyes and responds softly, “I am not arguing. I’m simply asking if we can just start a fluid bolus while I go get the crash cart to hook him up to the defibrillator and Dr. Gallagher isn’t wanting to wait that long. The patient is completely stable; he’s alert and oriented with his blood pressure in the 130s.”

Mickey notices the bag of fluids in her hands and he takes it and tells her to go get the crash cart. As she is leaving the room, Mickey hears Ian’s very audible sigh from behind him and imagines him throwing up his arms as well. While Mickey is connecting the fluid to the patient, he starts a conversation with the patient, who denies chest pain or feeling palpitations or any shortness of breath. Mickey explains that while he is stable for the time being, since his heart is beating so quickly, they are going to hook him up to the defibrillator just as a precaution. 

Mickey turns toward Ian, who glares at him and says under his breath, “I didn’t want fluids. And why does he need to be hooked up anyway?”

Mickey answers softly so not to worry the patient. “Have you never seen how adenosine works? It stops his heart and hopefully it starts back up again. We don’t exactly love it.” 

The nurse returns with the crash cart and she and Mickey connect the patient to the defibrillator. Mickey then explains to the patient, “We’re going to push some medicine through your IV and it’s going to feel pretty horrible for a few seconds. It’s going to slow down your heart really really slow, that’s when you’ll feel bad, then it’ll restart at a normal rate and rhythm.” 

The nurse draws the medication into the syringe while Mickey wets a washrag with cold water and places it on the patient’s forehead and places an emesis bag on the patient’s chest in case he vomits. The nurse is prepared with the medication and Mickey is prepared with the saline flush to push behind it. 

Dr. Arnecke is now standing at the doorway and he and Ian make eye contact. Then the nurse announces that on three she’ll push the med. Everyone takes a deep breath while she counts. She pushes the med, Mickey pushes the flush, and all eyes are on the monitor. It shows a few more beats of 188, then 140, 65, then a flat line. 

The patient dry heaves a couple times, then moaned and dropped his head back on the pillow. Four seconds seems like a long time when you’re staring at a monitor showing a patient without a heart rate. But then just as the textbooks describe, the monitor wakes up beating a normal rhythm with a rate of 78. The patient turns his head slightly and finishes vomiting while the nurse cleans out his mouth. Mickey checks their blood pressure while Ian just stands there, looking at Dr. Arnecke for guidance. He simply says, “Make sure all your orders and notes are in the computer,” then he leaves in search of his other resident.

As Mickey is disconnecting the patient from the defibrillator and cleaning the crash cart to take it back to the nurse’s station, Ian approaches and starts to apologize for his behavior, admitting that he didn’t realize that it actually stopped the heart. 

Mickey briskly interrupted, “Don’t apologize to me, apologize to my nurse.” Mickey returns the crash cart to it’s home and just stands in the center of the unit looking down each hall, seeing if all the staff looked okay. He sees Ian talking to his nurse and they’re both smiling and all seems well. 

Several uneventful hours pass when Mickey notices Ian falling asleep at one of the computers, his head leaning forward and then jerking back up. He approaches him from behind and sets a cup of coffee next to him. Ian’s head swings around quickly and his eyes light up at the sight of Mickey, causing Mickey to turn away, automatically seeing if anyone is noticing. “Oh my god, that smells wonderful. Thank you.” Then he takes a sip…”Oh my god, that’s awful,” with a little laugh.

“Eh, it’s from the lounge. You think we got a fucking Starbucks in there or something?” Mickey is trying to hide a little closed-mouth grin. Then he pulls up a chair next to Ian and logs onto the computer next to him so that he looks busy. “Sleep schedule all fucked up?’

Ian forces down another sip, “Seriously, this is just awful. Is this what we serve the patients?” Still chuckling under his breath, “Yeah. I worked nights the past four nights covering for Khan, then stayed over today to switch back. My brain is nothing but fuzz.”

Getting up from the desk, “Well, drink that and clear it out. Free refills.”

Code blues rarely happen in the ICU suddenly. I mean, occasionally, someone will just flip into a lethal rhythm. But usually, a patient will arrest after a period of deterioration where there is already multiple staff working on him. And Mickey always knows which patients are sick, not just sick that they need to be in the hospital, but sick – they’re trying to die. So when the code blue alarm rings from room three, Mickey is surprised.

By the time he makes it to the front hall, his nurses are already running the show – hooking the patient to the defibrillator, giving oxygen, and administering the first dose of epi (epinephrine – the first code drug given). The rest of the team arrives and a report is given to the code leader. The patient, post-op day one from a minor lung procedure, had gotten up to use the restroom and had just returned to bed when he suddenly went into respiratory distress. He was thrashing in the bed, extremely panicky, grasping at people’s arms and repeating, “Help me, I can’t breathe, I’m going to die, help me!” Then the patient turned slightly blue-purple around his lips, his head fell back and became unresponsive without a pulse. Mickey recognized this as a probable pulmonary embolism, which is a blood clot in the lung, also called a PE, and he got on a computer to check the patient’s medications. 

“His blood thinners didn’t get reordered after his procedure,” Mickey called out to the code team leader. 

Ian is standing next in line for compressions when he hears Mickey and realizes that he was the ordering physician last evening. His stomach jumped up as if trying to burst through his neck and he could hardly breathe. So he steps back and stands between Dr. Arnecke and Mickey and states, “I reordered all his meds, I just clicked the reorder box, I didn’t leave anything off.” 

Mickey continues his investigation of the patient’s meds and sees the mistake. “His blood thinners were on hold four days ago, so when you just hit reorder, they’re not listed.” Mickey’s voice is angry, he’s not yelling, but he’s firm and his voice carries in the small room. “You can’t just check boxes without looking at what the fuck you’re doing. Order the fucking TPA.” (“clot buster” – given during acute strokes or cardiac arrests caused by PEs. Ideally, you’d want to scan his chest to verify a clot but during a code, if it’s a reasonable assumption, we give it anyway) 

Ian gets in front of the computer and with shaky hands, he orders the TPA, then he asks Dr. Arnecke if he should reorder the blood thinner now. His heart sinks when he hears, “Not now – let’s see if he pulls through this.”

The patient did pull through – he responded appropriately to the TPA. Dr. Arnecke helps Ian with his orders and notes and they discuss the event and how the patient needs to be monitored closely for bleeding for the next 24 hours. Of course, Jennings is involved in the conversation as well and pipes in his opinion. “You need to stop that fucking nurse from talking to you that way. You’re a goddamn doctor and none of the nurses talk to us like that.”

Ian wishes he would shut the fuck up. “He was right though. I made a mistake and almost killed a patient. Do you expect him to just sit there and say nothing?”

Jennings steps closer to Ian and stares him down. “I expect you to demand respect from him; talking to a higher-up like that in front of everyone? You should write him up for insubordination or some shit.”

Ian’s eyes bounce off the back of his skull. “Oh my god. I am not writing him up for pointing out my mistake when I almost killed someone. Just get the fuck away from me,” Ian said as he pushes him aside and walks off. 

Dr. Arnecke is quiet during all this, watching his residents work through issues that all residents work through. He doesn’t intervene, knowing where it’s headed and trusting that it’ll work out in the end. He raises his eyebrows at Jennings and reminds him to keep an eye on the patient tonight. 

Jennings sits at the desk in front of the computer, watching the room clear out, all the people and then the crash cart returning to their rightful places. He turns toward the computer and is about to start checking on patients when he realizes that the computer is still logged on. It’s still logged on under Ian’s name.


	9. Chapter 9

All three voices simultaneously:

“Oh hell no, I’m not listening to this fucking shit!!” 

“Mickey, sit down.”

“I didn’t write that! I swear to god I didn’t write that. I don’t even know how to write an incident report.” Ian feels warmth spreading from his neck to his face, almost a panic that this is happening.

Doris makes eye contact with Dr. Arnecke who manages to keep his face unreadable. “You didn’t write an incident report stating that Mickey talked disrespectfully to you during the code a few days ago?” Doris keeps her eyes on Ian and keeps her hand out toward Mickey, as if trying to magically keep him in the chair.

“I promise I didn’t,” his face swings from Doris back to Mickey, “I swear, Mickey, you know I didn’t write that.” Ian pauses for a second and wrinkles his eyebrows. “When was that written?”

Doris looks back to the computer. “Monday. The day of the code.”

“What time was it written?”

“It was submitted at 5:30pm.”

Ian drops his head and nods back and forth, “I know what happened.” Ian turns toward Dr. Arnecke quickly and then directly to Mickey. 

“Jennings and I had words about how you talked to me during the code – he felt like I was letting you talk down to me – and he suggested that I write it up. I popped off to him and just walked away. I bet I left my computer up. I didn’t log out and he did that.” Turning back to Dr. Arnecke, “Jennings did that.” 

Doris looks at Ian with a sympathetic smile, then asks, “Does Mickey bark at you sometimes?”

And just as Mickey starts to get out of the chair with his mouth open, words right there on the tip of his tongue, Doris glances at him and he sits back down with a huff, crossing his arms and burning a hole through the wall. 

Ian tries to keep his chuckle fairly quiet. “Well, yeah,” full blown smile now. “But it’s okay. I mean, he’s always right.”

Doris throws out her famously warm smile. “It’s pretty irritating, isn’t it?”

“Hey assholes, I’m right here,” Mickey exclaims while throwing his hands out. 

The mood in the room lightened now, Doris turns to Dr. Arnecke and Ian and closes the conversation. “Alright guys, I think we’re good here. Mickey, stick around a minute if you don’t mind.”

Ian stands up and leaves the tiny office, then Dr. Arnecke turns back toward Doris and assures her, “It’ll be taken care of. Thanks.”

Alone in the office now with Mickey, Doris spins her chair around to her coffee pot and pours a fresh cup and hands it to him. “Well, that was weird. What’s going on there?”

Mickey is quick to respond, “Nothing. I mean, what do you mean?”

“I mean, what is going on there? Anything? He was desperate for you to know he didn’t do it. You’ve been under my wing for close to a decade now, Mickey. You know that I love you dearly. So I’ll ask again. What’s going on?” Mickey squirms in his chair, doesn’t answer, can’t even make eye contact. “Okay, so I’m going out on a limb here. You either want something or it’s already happening.”

He releases a heavy sigh. “I don’t know, Doris. I think we’re friends, maybe?” Mickey has trouble finding any more words. He readjusts in the seat and looks Doris squarely in the eye, waiting for her words that always bring comfort to him. 

She looks at him and just smiles warmly, and all he can do is smile in return. “Okay, so y’all are friends. And I assume there’s some underlying tension there, as well?”

“Hmm, well yeah. I mean, he’s fucking hot, ya know”

“Yes, for sure, very attractive. And I’m also going to assume that he feels the same way toward you?”

A warm blush starts to creep up from his check to his neck. “Yeah, he’s said as much,” followed by a small smile that he can’t seem to stop. 

Doris is having a difficult time containing her smile, then it’s a full blown laugh when she watches Mickey rest his forehead in his hand while nodding back and forth. “Mickey, honey, this is good. Okay, this is a good thing.”

They both just settle in their chairs for a bit, smiling at each other. Mickey has to look away just to quit smiling, then he looks up at her, silently asking what the fuck to do.

“So what’s the problem, Mickey?”

He moans, “Ugh, I don’t even know. You know I don’t date, I just fuck,” then quickly looks at her with a squinch in his eye. “Sorry, I just have eight-hour relationships.” Doris smiles, nods her head and motions her hands to continue. “He just feels different and I just don’t know if I’m ready for that.”

“Tell me the worst case scenario. You become involved for a while, and then it ends. Other than maybe a little awkwardness at work, which will quickly be buried by the demands here, how will your life be different after that? Worst case?”

“That’s just it. I don’t know what it’ll look like.” He sits up a little straighter now. “Every single time someone has come into our lives, it just gets more fucked up. I have no idea what Ian will do to it.”

“Oh Mickey, I get it, I really do. You had a tough upbringing with numerous bad hands dealt and you’ve been strong and focused for so long. You and Mandy both have decent lives solely because of you. But it’s okay to relax a little now. You can afford to relax now; no one can take away what you’ve worked for here.”

“I understand all that in theory and I ain’t worried about my job. It’s just the rest of it – I don’t know. My life is good now. I just feel like he’ll blow a fucking hole in it.”

“And the problem is that you actually want him to do just that.” 

His response is quick and firm, “No, I don’t.”

“Well, if you didn’t, this wouldn’t be bothering you.” Mickey’s response to that is to toss his empty styrofoam cup in the trash. Doris recognizes the conversation is over and while standing from her desk, jokes, “Sitting your ass in my office while on the clock – get back to work.” 

Mickey smiles his thank you and heads out to the unit. 

Ian leaves Doris’s office and sees Jennings heading into the doctor’s lounge to start his day. Ian lengthens his strides. Dr. Arnecke breaks out in a little jog behind him, thinking, ‘oh brother, here we go.’

Pounding the door into the wall, not even looking to see who else is in the lounge, Ian spins Jennings around by the shoulder. “What the actual fuck do you think you’re doing writing an incident report under my name? You don’t have the balls to do one yourself?”

Jennings huffs out a little laugh. “Oh please, you’re just upset that your little boyfriend is pissed.” 

“Excuse me?” 

Jennings steps forward, now face to face. “Yeah you heard me. The way you defended him at the bar last week and then fell all over him trying to kiss his ass. Fucking faggo-”

It was a solid hit to the left cheek. Jenning’s head whipped back, hitting the lockers and then the bench on his way to the floor. Ian grabs his shirt by both hands and is right in his face. “Look at my face, motherfucker, you see my face? You got it memorized? You’ll never say another word like that to me again. Got it?” Ian lets go of Jenning’s shirt and watches him land in a puddle on the floor. 

Ian walks to his locker, puts on his ironed and starched white coat and checks his hair in the mirror. Dr. Arnecke watches Jennings pick himself up off the ground, using the bench as support since no one in the lounge offered to help him. 

“Well, okay then. Let’s go round.” 

Mickey opens the manager’s door just as the trio of doctors is walking by, Jennings bringing up the rear, the beginnings of a black eye already showing. He sucks in his lower lip and ducks his head, trying to hold his smile. Doris playfully nudges him with her shoulder. “You’re gonna need to give this a go, Mickey.”

The old friends make quick eye contact. “Hmm, yeah…..maybe.”

**Author's Note:**

> Medical terms that might help
> 
> Central line - an IV access inserted into major vessels rather than the arms; beneficial for critically ill patients because several medications can be given at once through multiple ports; inserted into the femoral vein in the groin area, the internal jugular in the neck or in the subclavian vein in the chest area above where the heart is.
> 
> Pneumothorax - when air leaks into the space between the lungs and the chest wall; a common complication of central line insertions when the provider is utilizing the subclavian vein.
> 
> Chest Tube - a flexible plastic tube inserted through the chest wall into the space between the chest wall and lungs; used to remove air in the case of pneumothorax or fluid if fluid is collected there.


End file.
